Stripes311

OP- First off, you are not an idiot! I would've called 911 for an ambulance as well. It sounds like you knew in your gut 911 would've been the best decision but you left the decision in the hands of the patient rather than calling right away. It is not easy being alone in someone's home with their family members all around, not having other nurses right there to help you and bounce ideas off of. Sounds like a good learning experience for you and all of us reading this to follow our intuition and err on the side of caution for the patient's safety. Best of luck to you! :)

Hi, don't give up, keep hitting up job websites everyday and putting your application in. It can be stressful and frustrating but keep working at it! Like previous posters noted, be prepared to look outside of your current location- you may have to commute a longer distance or relocate. I agree with flyersfan88- make sure to proofread your grammar and spelling in your documents that you're sending out- resume, cover letter and every single thing you type in the application cannot have errors. Best of luck on your job hunt!!

Hi TeleRN, congrats on the offers- both sound like exciting opportunities that you would grow from! I agree with NedRN and suggest getting another year under your belt. The floating ICU position sounds very challenging, you will need to learn the ropes in four different facilities... you will no doubt become a stronger and more resilient nurse after a position like that. It will definitely make you more marketable as a travel nurse- it will show that you're flexibility and well rounded. Good luck with whatever you decide!

Hello, I think there is definitely a chance you can get hired as a chart review nurse if you are still looking. There are many HEDIS nurse openings around the country right now, it's the HEDIS season for every insurance company and they need nurses now until mid May. My advice would be to check on indeed.com or monster.com and type in HEDIS NURSE and you will see there are many openings- hopefully some in a commutable distance for you unless you can find a work from home one which is more difficult. Also, try to work through recruiters from staffing agencies- they are usually very helpful and work hard to place you at a job. Best of luck on your job hunt.

Wow your positive attitude and enthusiasm is excellent and will serve you well! I would suggest arriving a bit early each day so you can compose and prepare yourself for your shift, take every opportunity to practice your skills (such as IVs, foleys, wound vacs), consider carrying around a little pocket guide such as "Tarascon Pocket Pharmacopoeia" so you can look up each med you are unsure of, help your CNA whenever you can. Also, I would suggest writing things down throughout the shift rather than thinking you'll remember it when it's time to chart! It's so easy to forget how many cc's of urine you dumped or what the BP was before you gave a med, or what time you reassessed pain after you gave a prn med. Like the above post noted- always ask questions along the way! Congratulations on your upcoming graduation and I wish you the best of luck wherever you plan on working! :)

Unfortunately the ratios in LTC settings are high and it is overwhelming. I worked as an agency nurse and only lasted a few shifts in the LTC setting- I give all LTC nurses so much credit. It sounds like it is a newer job for you, my main advice is to try to think of ways you can manage your time as efficiently as possible. I'm sure there are some great threads in the LTC section with ideas to be more successful from other LTC nurses. Perhaps as you get to know the residents more your assessments and med routine will go a lot quicker. You have to make sure you take care of yourself though and go to the bathroom when you need to and take water and snack breaks during the shift- you deserve to be taken care of just like you're taking care of all of your residents.

Hi snider1970, You put in a lot of work to complete the ADN course and pass the NCLEX and you are continuing to work hard to complete your BSN. I understand your disappointment and frustration, working in a LTC setting is very difficult- the patient load is heavy. You may want to step back and take some time out to make a thorough list and evaluate each of your concerns and what you can do about them. You mentioned being concerned about losing skills- you are using a lot more skills than you are giving yourself credit for! 20-30 patients a shift is A LOT! You are honing time management skills that will make your transition to the hospital setting a lot easier. I want to offer a few suggestions too that may help you feel more in control of your situation: -You mentioned some patients are on antibiotics. You can make sure to stay on top of the IV assessments, if they are peripheral you can let fellow nurses you want to change it when they are due to be changed. If they are central lines- you can do the dressing changes on the appropriate day. -Depending on your facility's policy, if applicable offer to change out foley catheters when necessary. -You can review heart rhythms online and work on getting your ACLS down the road. It is empowering and will be necessary on many inpatient units. The first year in nursing is extremely stressful and full of emotional ups and downs. You are honing your assessment, time management and communication skills with patients and fellow staff members. It's not easy. I remember crying on my way to work many days wondering what I was doing, I thought about quitting my job daily! You can get through this and you will get stronger, it just takes time. Perhaps doors will open up and you will be able to transition into the acute care setting sooner, but in the meantime try to find joy outside of work and do things that bring you happiness. Best of luck in your journey!

Totally agree with NedRN! Great info!

Hello whodatrn, Congrats on your job offers! If you did not sign a contract you are not committed to work an assignment for that travel company. You may want to find out more information about each offer before you decide which one to accept. It's always best to follow your gut and do what's right for you and your family! :)

Hi icuRNmaggie! It was Medical Staffing Solutions. I don't think their stipend was $2000 for housing but they did find nice private housing for me and covered it 100%. Hopefully they still do.

Hi 88nurse2010, I did two assignments in Hawaii a few years ago and I had a more positive experience than the previous poster. You are smart to start the research process right now of islands, hospitals and companies. It's also good you already have some travel experience under your belt so you know the pressures and expectations of a travel nurse. The company you work for will truly make or break your experience in Hawaii. Being so far away from home and getting tossed into a brand new job with new people, policies and procedures is hard enough... having a company that doesn't fully provide you with things you need makes it even more difficult. Through my personal experience may I suggest that you require the following from a travel company if you're going to Hawaii: 1. Provides housing. My company fully provided housing. I had the choice between a stipend or their housing. I took their housing they found because I didn't feel like dealing with the hassle of looking for my own. If you are going with a friend or craigslist savvy though that's of course an option. 2. Pay for your ENTIRE flight. ENTIRE FLIGHT... not a stipend there and back. 3. Pay for your ENTIRE car. ENTIRE CAR... I can't stress this enough. You're going to land at that airport and be excited and nervous. Trying to haggle with independent people who rent their car to travelers, or paying the money to personally rent from a reputable dealer from an airport gets so so so expensive and stressful. (That happened to me the first time around). As travelers we already know we need to earn the respect of the staff to survive. Although we can't control other's opinions about us in life I think if you go in with a positive attitude willing to work hard and help others on your floor you will thrive along with your patients. You may not make the "big bucks" in Hawaii but like every assignment it is exactly what you make of it. Outside of work there is so much to do. Each island is so beautiful and unique. Even in Hawaii there's definitely days that are tough for different reasons. But like all travel assignments you will meet special people and make memories because you put yourself out there and tried something new. I can't stress enough about the housing, car and flight. You need to find out right off the bat what the company you're considering provides for Hawaii travelers. Most times it is not up to the recruiters, it's the company. It doesn't mean that they are a bad company, they may be excellent for a mainland assignment but for a Hawaii assignment you really ought to think about what you want... it is intimidating at times asking these questions to recruiters because you don't want to appear rude or presumptuous but please remember you're going to be the one out there by yourself not them. I wish you and anyone else the best of luck on your Hawaii endeavors! I say... go for it! :)

Thank you both for your responses, I appreciate it the insight.

Hello flnrn72! That's awesome you're looking into travel nursing. I've been doing it for a couple years now, it's a great experience. I think your 3 years of acute care experience with ICU/ER patients would be something hospitals hiring travelers would be interested in. You sound flexible and that's a great quality in this type of field. Have you talked to any recruiters yet? If not you could always email a few different companies. That's a great place to start to get more of an idea of what's involved in terms of hospital needs and requirements. Good luck!! :)

Hello, I have been an RN for several years and I am looking to eventually move away from bedside nursing and have developed an interest in case management. I was just wondering if anyone would be able to give their insight and knowledge into the key differences between a hospital based RN Case Manager and Social Worker? I work with them each day on the floor and know how busy and hectic their jobs are, but I don't fully understand what they do along with the transfer and discharging of patients. What is a typical day like? What are some challenges and joys of being an RN case manger? Thanks so much for your time!! :)